what is anesthesia?
who administers anesthesia?
who gets what type
topical, cold, cream
injection, tumescent, ring block, regional block
IV sedation / monitored
stages of general anesthesia
preparing for anesthesia
anesthesia and herbal
anesthesia and prescription
Stages of General Anesthesia
There are four stages of general anesthesia:
- "going under"
- "coming out"
The premedication stage uses sedating medications,
usually Versed, to calm and relax the patient before
entering the operating room.
The second stage, "going under" is also sometimes
referred to as induction. During this stage, strong
drugs are given through an intravenous (IV) line to
put the patient to sleep and control pain. (A face mask
can also be used, but this is usually now done just
After going under, the patient may be so sleepy that
the tongue falls back in the mouth and blocks the airway.
To prevent this, the airway must be protected and this
can be accomplished in one of three ways: intubation,
laryngeal mask, or manually. With intubation, a plastic
tube (endotracheal tube) is inserted into the windpipe.
This can sometimes cause hoarseness or a sore throat
for a few days after surgery.
A newer technique that has been used increasingly over
the last 10 years is called a laryngeal mask airway
(LMA). The LMA doesn't enter the windpipe, but forms
a seal around it to ensure that air is flowing into
it, and minimizing the risk of trauma to the throat.
The third method to protect the airway is by lifting
the chin and moving the jaw forward. Since this requires
someone to hold the patient in that position, it is
only used for brief amounts of time.
For longer procedures, a small drain will be placed
into the bladder to drain urine (urinary catheter).
This will prevent the patient from having to urinate
during or immediately after the operation, and is especially
helpful since such large amounts of fluid are given
through the IV. Sometimes, especially with abdominoplasty,
the catheter is left in for a few days after surgery
to keep the patient from having to get up every hour
or so to urinate while the excess fluid is excreted.
During the maintenance phase of anesthesia, the patient
is kept comfortable and vital signs are monitored. In
some cases, the maintenance phase may last for several
hours while the surgeon performs the operation. During
this time inhaled anesthetics (medication in a gaseous
form) can be administered with or without the help of
a ventilator (breathing machine).
Finally, near the end of the operation, the anesthetic
vapors are turned down and the patient slowly regains
consciousness before being transferred to the post-anesthesia
care unit (PACU), also known as the recovery room. This
is the "coming out" stage.
To Next Section
- Preparing For Anesthesia